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Good Cholesterol (HDL) Is More Important Than You Think

Heart disease is the number one killer of Americans, and high cholesterol levels are a primary contributor to heart disease. But the cholesterol story is a bit complicated – some of it is damaging to blood vessels (Low Density Lipoproteins or LDL is considered “bad” cholesterol) and some of it is restorative (High Density Lipoproteins or HDL is “good” cholesterol). Most medications are aimed at lowering the “bad” cholesterol, and this strategy has been very helpful in reducing heart disease and atherosclerosis. But what about raising the good cholesterol as part of a heart healthy strategy?

A new study in the New England Journal of Medicine suggests that having low levels of HDL can put people at risk for heart disease and heart attacks, even if the LDL is well controlled.  This is the first study to show that low LDL does not erase heart disease risk if the individual’s HDL is also low.  In fact, each increase of 1 mg in HDL cholesterol is associated with a decrease of 2 to 3% in the risk of future coronary heart disease.  So lowering LDL with statins (if lifestyle measures fail) is only half the battle for those who also have low HDL.So how do you increase your HDL levels?The most effective medicine for raising HDL is a type of Vitamin B called niacin.  Taken in the quantities required to have an effect on HDL, though, there are usually unpleasant side effects: flushing (redness or warmth of the face), itching, stomach upset, mild dizziness, and headache.

Perhaps the best way to increase HDL is to lose weight and exercise regularly.? In fact, the list of HDL-raising “to do’s” reads like a healthy living manual:

1.  Avoid trans fats

2. Drink alcohol in moderation

3.  Add fiber to your diet

4.  Use monounsaturated fats like olive oil where possible

5. Stop smoking

6. Lose weight

7. Engage in regular aerobic exercise

So next time you see your doctor, make sure you review your cholesterol levels, and discuss some strategies to get your levels of HDL and LDL in the optimal zones for a healthy heart.This post originally appeared on Dr. Val’s blog at

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2 Responses to “Good Cholesterol (HDL) Is More Important Than You Think”

  1. Dr. Scherger says:

    Very important message Val.  The Framingham study also showed that of all the lipid patterns that cause a risk for heart disease, a low HDL cholesterol was the worst.

    I want to give an extra plug for aerobic exercise.  I was able to raise my HDL from 37 (low and risky) to 52 (great for a man) by starting to run 20 miles a week.  My level has stayed in the low 50s with running.  20 miles a week takes about as much time as a round of golf.

  2. youngold says:

    Interesting…However,  when a person (male) such as myself has been a runner/swimmer  since  about 5 years old..(Now 68), even with “niacin”  my HDL never  moves  from 40 !What  has to be addressed is the  genetic factor!   In  addition to HIV and other “pre-marital tests” required by many states…I humbly suggest a “genetic profile”  should be required  to help decide of having a child  with a  potentially shortened lifespan is  a wise  decision. I am aware that this  sounds like “selective  breeding.” But why not?  It is done  successfully in the animal world.  Personally,  If  I knew that my “X” had  certain  mental and physical traits  that could be inherited  I would never  have  married  her!!!   My only son son died at 33 !!!

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